My vaginal dryness was causing pain associated with having sex and multiple urinary tract infections. I had had only two UTIs in my lifetime before menopause. While I tried a commercial vaginal hormone cream, I had frequent and severe hot flashes on the lowest dose given two times a week. When I switched to the compounded hormone it was a lower concentration of hormone given three times a week. The hot flashes stopped while still controlling the vaginal dryness and its consequences.